Improvement of Conflict Handling: Hand-Holding During and After Conflict Discussions Affects Heart Rate, Mood, and Observed Communication Behavior in Romantic Partners.

Improved conflict handling is important to reduce relational discord. Touch potentially has beneficial effects on three important characteristics of conflict discussions, i.e., physiological reactivity, affect and communication behavior. We studied effects of hand-holding between partners during conflict discussions (N = 47 student couples) and after conflict discussions (N = 53 student and N = 45 clinical couples). During conflict discussions hand-holding caused lower heart rate reactivity, higher positive affect and improved communication in men, and in women lower positive affect but improved communication. After conflict discussions hand-holding resulted in lower heart rate reactivity and higher heart rate variability in student couples and higher positive affect in student and clinical couples. Touch seems a promising add-on intervention in couple therapy.

On-chip free beam optics on a polymer-based photonic integration platform.

This paper presents on-chip free beam optics on polymer-based photonic components. Due to the circumstance that waveguide-based optics allows no direct beam access we use Gradient index (GRIN) lenses assembled into the chip to collimate the beam from the waveguides. This enables low loss power transmission over a length of 1432 µm. Even though the beam propagates through air it is possible to create a resonator with a wavelength shift of 0.002 nm/°C, hence the allowed deviations from the ITU-T grid (100 GHz) are met for ± 20 °C. In order to guarantee reliable laser stability, it is necessary to implement optical isolators at the output of the laser. This requires the insertion of bulk material into the chip and is realized by a 1050 µm thick coated glass. Due to the large gap of the free-space section, it is possible to combine different resonators together. This demonstrates the feasibility of an integrated wavelength-meter.

Symptom-specific course trajectories and their determinants in primary care patients with Major Depressive Disorder: Evidence for two etiologically distinct prototypes.

BACKGROUND: The course-heterogeneity of Major Depressive Disorder (MDD) hampers development of better prognostic models. Although latent class growth analyses (LCGA) have been used to explain course-heterogeneity, such analyses have failed to also account for symptom-heterogeneity of depressive symptoms. Therefore, the aim was to identify more specific data-driven subgroups based on patterns of course-trajectories on different depressive symptom domains. METHODS: In primary care MDD patients (n=205), the presence of the MDD criterion symptoms was determined for each week during a year. Weekly 'mood/cognition' (MC) and 'somatic' (SOM) scores were computed and parallel processes-LCGA (PP-LCGA) was used to identify subgroups based on the course on these domains. The classes׳ associations with baseline predictors and 2-/3-year outcomes were investigated. RESULTS: PP-LCGA identified four classes: quick recovery, persisting SOM, persisting MC, and persisting SOM+MC (chronic). Persisting SOM was specifically predicted by higher baseline somatic symptomatology and somatization, and was associated with more somatic depressive symptomatology at long-term follow-up. Persisting MC was specifically predicted by higher depressive severity, thinking insufficiencies, neuroticism, loneliness and lower self-esteem, and was associated with lower mental health related quality of life and more mood/cognitive depressive symptomatology at follow-up. LIMITATIONS: The sample was small and contained only primary care MDD patients. The weekly depression assessments were collected retrospectively at 3-month intervals. CONCLUSIONS: The results indicate that there are two specific prototypes of depression, characterized by either persisting MC or persisting SOM, which have different sets of associated prognostic factors and long-term outcomes, and could have different etiological mechanisms.

Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: individual patient data meta-analysis.

BACKGROUND: The association between depression after myocardial infarction and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity. AIMS: To combine original data from studies on the association between post-infarction depression and prognosis into one database, and to investigate to what extent such depression predicts prognosis independently of disease severity. METHOD: An individual patient data meta-analysis of studies was conducted using multilevel, multivariable Cox regression analyses. RESULTS: Sixteen studies participated, creating a database of 10 175 post-infarction cases. Hazard ratios for post-infarction depression were 1.32 (95% CI 1.26-1.38, P<0.001) for all-cause mortality and 1.19 (95% CI 1.14-1.24, P<0.001) for cardiovascular events. Hazard ratios adjusted for disease severity were attenuated by 28% and 25% respectively. CONCLUSIONS: The association between depression following myocardial infarction and prognosis is attenuated after adjustment for cardiac disease severity. Still, depression remains independently associated with prognosis, with a 22% increased risk of all-cause mortality and a 13% increased risk of cardiovascular events per standard deviation in depression z-score.

Work-related post-traumatic stress disorder.

BACKGROUND: Work-related post-traumatic stress disorder (PTSD) is an important condition encountered by many occupational health practitioners. AIMS: To carry out an in-depth review of the research on occupational groups that are at particular risk of developing work-related PTSD. METHODS: A literature search was conducted in the databases OVID MEDLINE, OVID Embase, Ovid PsycINFO, ISI Web of Science and CSA Health and Safety Science Abstracts. RESULTS: Professionals such as police officers, firefighters and ambulance personnel often experience incidents that satisfy the stressor criterion for the PTSD diagnosis. Other professional groups such as health care professionals, train drivers, divers, journalists, sailors and employees in bank, post offices or in stores may also be subjected to work-related traumatic events. Work-related PTSD usually diminishes with time. CONCLUSIONS: Mental health problems prior to the traumatic event and weak social support increase the risk of PTSD. Prevention of work-related PTSD includes a sound organizational and psychosocial work environment, systematic training of employees, social support from colleagues and managers and a proper follow-up of employees after a critical event.

An increase in depressive symptoms after myocardial infarction predicts new cardiac events irrespective of depressive symptoms before myocardial infarction.

BACKGROUND: Depression after myocardial infarction (MI) is associated with poor cardiovascular prognosis. There is some evidence that specifically depressive episodes that develop after the acute event are associated with poor cardiovascular prognosis. The aim of the present study was to evaluate whether an increase in the number of depressive symptoms after MI is associated with new cardiac events. METHOD: In 442 depressed and 325 non-depressed MI patients the Composite International Diagnostic Interview interview to assess post-MI depression was extended to evaluate the presence of the ICD-10 depressive symptoms just before and after the MI. The effect of an increase in number of depressive symptoms during the year following MI on new cardiac events up to 2.5 years post-MI was assessed with Cox regression analyses. RESULTS: Each additional increase of one symptom was significantly associated with a 15% increased risk of new cardiac events, and this was stronger for non-depressed than for depressed patients. This association was independent of baseline cardiac disease severity. There was no interaction with the number of depressive symptoms pre-MI. CONCLUSIONS: Our findings suggest that an increase in depressive symptoms after MI irrespective of the state of depression pre-MI explains why post-MI depression is associated with poor cardiovascular prognosis. Also increases in depressive symptoms after MI resulting in subthreshold depression should be evaluated as a prognostic marker. Whether potential mechanisms such as cardiac disease severity or inflammation underlie the association remains to be clarified.

Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study.

BACKGROUND: Residual depressive symptomatology constitutes a substantial risk for relapse in depression. Treatment until full remission is achieved is therefore implicated. However, there is a lack of knowledge about the prevalence of (1) residual symptoms in general and (2) the individual residual symptoms in particular. METHOD: In a 3-year prospective study of 267 initially depressed primary care patients we established per week the presence/absence of the individual DSM-IV depressive symptoms during subsequent major depressive episodes (MDEs) and episodes of (partial) remission. This was accomplished by means of 12 assessments at 3-monthly intervals with the Composite International Diagnostic Interview (CIDI). RESULTS: In general, residual depressive symptomatology was substantial, with on average two symptoms present during remissions. Three individual symptoms (cognitive problems, lack of energy and sleeping problems) dominated the course of depression and were present 85-94% of the time during depressive episodes and 39-44% of the time during remissions. CONCLUSIONS: Residual symptoms are prevalent, with some symptoms being present for almost half of the time during periods of remission. Treatment until full remission is achieved is not common practice, yet there is a clear need to do so to prevent relapse. Several treatment suggestions are made.

Short-term effects of enhanced treatment for depression in primary care: results from a randomized controlled trial.

BACKGROUND: Depression is a highly prevalent, often recurring or persistent disorder. The majority of patients are initially seen and treated in primary care. Effective treatments are available, but possibilities for providing adequate follow-up care are often limited in this setting. This study assesses the effectiveness of primary-care-based enhanced treatment modalities on short-term patient outcomes. METHOD: In a randomized controlled trial we evaluated a psycho-educational self-management intervention. We included 267 adult patients meeting criteria for a DSM-IV diagnosis of major depressive disorder, assessed by a structured psychiatric interview. Patients were randomly assigned to: the Depression Recurrence Prevention (DRP) program (n=112); a combination of the DRP program with psychiatric consultation (PC+DRP, n=39); a combination with brief cognitive behavior therapy (CBT+DRP, n=44); and care as usual (CAU, n=72). Follow-up assessments were made at 3 months (response 90%) and 6 months (85%). RESULTS: Patient acceptance of enhanced care was good. The mean duration of the index episode was 11 weeks (S.D.=9.78) and similar in CAU and enhanced care. Recovery rate after 6 months was 67% overall; 17% of all participants remained depressed for the entire 6-month period. CONCLUSION: Enhanced care did not result in better short-term outcomes. We found no evidence that the DRP program was more effective than CAU and no indications for added beneficial effects of either the psychiatric evaluation or the CBT treatment to the basic format of the DRP program. Observed depression treatment rates in CAU were high.

Neural modulation of visuomotor functions underlying prey-catching behaviour in anurans: perception, attention, motor performance, learning.

The present review points out that visuomotor functions in anurans are modifiable and provides neurophysiological data which suggest modulatory forebrain functions. The retino-tecto/tegmento-bulbar/spinal serial processing streams are sufficient for stimulus-response mediation in prey-catching behaviour. Without its modulatory connections to forebrain structures, however, these processing streams cannot manage perceptual tasks, directed attention, learning performances, and motor skills. (1) Visual prey/non-prey discrimination is based on the interaction of this processing stream with the pretectal thalamus involving the neurotransmitter neuropeptide-Y. (2) Experiments applying the dopamine agonist apomorphine in combination with 2DG mapping and single neurone recording suggest that prey-catching strategies in terms of hunting prey and waiting for prey depend on dose dependent dopaminergic adjustments in the neural macronetwork in which retinal, pretecto-tectal, basal ganglionic, limbic, and mesolimbic structures participate. (3) Visual response properties of striatal efferent neurones support the concept that ventral striatum is involved in directed attention. (4) Various modulatory loops involving the ventral medial pallium modify prey-recognition in the course of visual or visual-olfactory learning (associative learning) or are responsible for stimulus-specific habituation (non-associative learning). (5) The circuits suggested to underlie modulatory forebrain functions are accentuated in standard schemes of the neural macronetwork. These provide concepts suitable for future decisive experiments.

Forebrain and midbrain structures involved in prey-catching behaviour of toads: stimulus-response mediating circuits and their modulating loops.

In anurans, visual prey information is filtered in the retina and processed in interacting pretectal and tectal retinal projection fields. Neuropeptide Y is involved in pretecto-tectal inhibition. Information related to prey and its location in space is transmitted to the bulbar/spinal motor pattern generating systems by ensembles of efferent tectal and tegmental neurons. This basic stimulus-response (S-R) mediating circuit is influenced by forebrain loops. It is suggested that ventral striatum and lateral thalamic nucleus participate in a loop responsible for gating S-R. The hippocampal pallium modifies S-R via the anterior thalamus with regard to previous experience. Dopaminergic modulation influences prey-catching strategies.

Responses of single neurons in the toad's caudal ventral striatum to moving visual stimuli and test of their efferent projection by extracellular antidromic stimulation/recording techniques.

Previous work in anuran amphibians has shown that activity in the caudal ventral striatum correlates with visuomotor activity: orienting responses toward prey fail to occur after striatal lesions. Thus it has been suggested that the striatum influences visually guided behavior. Therefore, the present study investigates visual response properties from neurons recorded in the striatum. Extracellular recordings of 104 single neurons of the cane toad's (Bufo marinus) caudal ventral striatum (STR) reveal five different response properties: resting discharge activity uninfluenced by the visual test stimuli (group STR1, 24.0%); resting discharge activity increased by any moving visual object (STR2, 31.7%); preference to moving compact objects (STR3, 15.4%); preference to certain configurational moving objects (STR4a and b, 13.5%), and resting activity reduced by visual stimuli (STR5, 15.4%). The receptive fields of these neurons encompassed the contralateral (46%) or the entire field of vision (54%). Of the neurons recorded in the striatum, 34% responded to electrical stimuli applied in the rostral diencephalon to the ipsilateral lateral forebrain bundle (LFB) which connects the striatum with the optic tectum (e.g. either directly or via pretectum or tegmentum). Various electrically driven STR neurons (40%) have axons that project caudally through the LFB, which was suggested by their antidromic activation in response to electrical stimuli applied to the LFB in the rostral diencephalon. In the present study, the main striatal output is mediated by 'motion detectors' (STR2) and 'compact object perceivers' (STR3). It is suggested that the caudal ventral striatum is involved in visual attentional processes that allow the translation of perception into action.

Adenocarcinoma arising in Crohn's disease: report of two cases.

Crohn's disease of the colon and small bowel is associated with a greater-than-chance increased incidence of adenocarcinoma, which also differs from the norm in age and anatomic distribution. The cancer risk appears to rise with earlier age of onset and long duration of the granulomatous disease, and the prognosis is relatively poor, probably due to difficulty in diagnosis because of the overlapping Crohn's disease. Two additional cases of adenocarcinoma arising in Crohn's disease are described.

Regional distribution of vascular resistance in two models of experimental renovascular hypertension.

The regional distribution of the peripheral vascular resistance was studied in normotensive and hypertensive Wistar rats. Two models of experimental hypertension were investigated: (I) in 32 animals the right renal artery was constricted by a silver clip (two-kidney Goldblatt hypertension); (II) in 46 animals the left kidney was removed and the right renal artery was clipped as in the first group (one-kidney Goldblatt hypertension). The normotensive control group comprised 61 untreated animals of the same strain and age. The distribution of cardiac output to 14 tissues was determined by means of the particle distribution technique. The resistance was increased in all regions investigated, a decreased or unchanged resistance was not observed. For most of the investigated tissues the regional resistance was increased exactly in proportion to the total peripheral resistance (TPR). Exceptions to this were found in 2 regions where the change of local resistance deviated from that of TPR: the splanchnic area and the skeletal muscle. In both cases the 2 models differed from each other. In the two-kidney model the increase of resistance in the splanchnic circulation was more intense than in other organs. In contrast, in the one-kidney model the local change of resistance was less than that of TPR. The change of skeletal muscle resistance was not significantly different from the change of TPR in the two-kidney model, while in the one-kidney model the increase of local resistance was significantly higher than that of TPR. It is concluded that the etiology of the abnormal resistance is different in the 2 models investigated and that known extrinsinc pressor factors may play a role in the two-kidney, but not in the one-kidney Goldblatt hypertension.

[Synchronization of estrus in heifers with BOVISYNCHRON]. / Versuche zur Brunstsynchronisation bei Färsen mit BOVISYNCHRON

Heifers were each given 2ml of 1% solution of chlormadinone (CAP, Bovisynchron) for 15 days. Those in group I received one daily dose, while group II received half the dose twice a day. Oestrus was synchronized in all but two heifers. In group II there was a concentrated occurrence of oestrus, so that all heifers could be inseminated on the 5th and 6th days, and earlier inseminations were not needed. This decreased the time required and the number of semen pellets. Results of insemination in two of the three subgroups of group II were 51% in one and 61% in the other, compared with between 32 and 39% in the other subgroup and in group I. Ways of improving the results are discussed.